Individual provider Active NPI

Kathryn Adams Dumont, LCSW

  • Clinical Social Worker
  • Lakeland, FL
National Provider Identifier
1578860029
Registry record updated Jan 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW8308 Issued in FL
Practice address
1867 N Crystal Lake Dr
Lakeland, FL 33801
Phone
(863) 450-3626
Fax
(863) 274-2237
NPI assigned
Feb 18, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW8308 FL Primary

Addresses

Primary practice location

1867 N Crystal Lake Dr
Lakeland, FL 33801

Mailing address

1867 N Crystal Lake Dr
Lakeland, FL 33801
Phone (863) 450-3626

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Oct 1, 2025 through Oct 1, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atala Counseling, PLLC Clinical PastSince Jan 17, 2021 Accepting new patients
Blue Moon Senior Counseling Clinical PastSince Jul 28, 2012 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1297987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610668800000",
    "number": "1578860029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 N CRYSTAL LAKE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33801",
            "telephone_number": "863-450-3626",
            "fax_number": "863-274-2237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1867 N CRYSTAL LAKE DR",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "33801",
            "telephone_number": "863-450-3626",
            "fax_number": "863-274-2237"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMONT",
        "first_name": "KATHRYN",
        "middle_name": "ADAMS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-02-18",
        "last_updated": "2021-01-15",
        "certification_date": "2021-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW8308",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

Verify at the official NPI Registry.